Table 1

Guidelines and practice concerning deferred Cord Clamping and cord milking for very preterm birth in 7 practising sites in the UK 2012

SiteGuideline content pertaining to DCC in very preterm birthGuideline content pertaining to CM in very preterm birthReported practice of DCCReported practice of CMRecommended duration DCCDuration reported in practiceSpecific instructions about execution of CM in guideline (number of milkings, length of cord, height of baby etcDelivery into plastic bag prior to cord ligation mandated in guidelineGuideline exclusionsComments
Site 1
Tertiary Hospital
Presented as alternative optionsVery fewAllNone5–10 sNoNoMost babies <28 weeks delivered by caesarean section had CM—more variability at higher gestations
Site 2
tertiary hospital
6000–7000 deliveries
DiscouragedRecommendedFew‘standard practice’NA?YesYesCM seen as safer than DCC in all circumstances
Site 3
medium size district hospital
5000–6000 deliveries
RecommendedOnly if DCC seen as unsafe70% in recent auditMinority30 s30sNoNoNoneDCC considered as part of resuscitation process
Site 4
tertiary hospital
6000–7000 deliveries
NilNilMinorityMinorityNo recommendation?NoNoDCC recommended for term births
Site 5
tertiary hospital
RecommendedNilMajority <28 weeksFew, if any45 s30 sNoNoNeed for immediate resuscitation.
Absent cord pulsation, or cord incised.
Placental separation.
Concerns for health of mother
Site 6
smaller district hospital
2000–3000 births
DiscouragedNilMinorityMinorityDiscouraged0–30 sNoNo‘The consensus paediatric view, therefore, is that DCC should not be practised routinely on preterm babies.,
Policy advised CM where DCC could not be achieved.
Site 7
4000–5000 births
tertiary hospital
NilNilMinorityMinorityNA15–60 sNoNoNone
  • CM, cord milking/stripping; DCC, deferred cord clamping.